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Randomized Controlled Trial
. 2016 Jun 28;8(7):397.
doi: 10.3390/nu8070397.

Beneficial Effect of Synbiotic Supplementation on Hepatic Steatosis and Anthropometric Parameters, But Not on Gut Permeability in a Population with Nonalcoholic Steatohepatitis

Silvia M Ferolla  1 , Cláudia A Couto  2 , Luciana Costa-Silva  3 , Geyza N A Armiliato  4 , Cristiano A S Pereira  5 , Flaviano S Martins  6 , Maria de Lourdes A Ferrari  7 , Eduardo G Vilela  8 , Henrique O G Torres  9 , Aloísio S Cunha  10 , Teresa C A Ferrari  11
Affiliations
Randomized Controlled Trial

Beneficial Effect of Synbiotic Supplementation on Hepatic Steatosis and Anthropometric Parameters, But Not on Gut Permeability in a Population with Nonalcoholic Steatohepatitis

Silvia M Ferolla et al. Nutrients. .

Abstract

Nonalcoholic fatty liver disease is the most prevalent chronic liver disease in Western countries; it can progress to nonalcoholic steatohepatitis (NASH), cirrhosis and hepatocarcinoma. The importance of gut-liver-adipose tissue axis has become evident and treatments targeting gut microbiota may improve inflammatory and metabolic parameters in NASH patients. In a randomized, controlled clinical trial, involving 50 biopsy-proven NASH patients, we investigated the effects of synbiotic supplementation on metabolic parameters, hepatic steatosis, intestinal permeability, small intestinal bacterial overgrowth (SIBO) and lipopolysaccharide (LPS) serum levels. Patients were separated into two groups receiving Lactobacillus reuteri with guar gum and inulin for three months and healthy balanced nutritional counseling versus nutritional counseling alone. Before and after the intervention we assessed steatosis by magnetic resonance imaging, intestinal permeability by lactulose/mannitol urinary excretion and SIBO by glucose breath testing. NASH patients presented high gut permeability, but low prevalence of SIBO. After the intervention, only the synbiotic group presented a reduction in steatosis, lost weight, diminished BMI and waist circumference measurement. Synbiotic did not improve intestinal permeability or LPS levels. We concluded that synbiotic supplementation associated with nutritional counseling seems superior to nutritional counseling alone for NASH treatment as it attenuates steatosis and may help to achieve weight loss.

Keywords: gut microbiota; hepatic steatosis; intestinal permeability; lipopolysaccharide; nonalcoholic fatty liver disease; nonalcoholic steatohepatitis; obesity; probiotic; synbiotic; weight loss.

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Figures

Figure 1
Figure 1
Comparison of the values of the hepatic proton density fat fraction (PDFF) using magnetic resonance image (MRI) in the study group and in the control group after intervention.
See this image and copyright information in PMC

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